Therapy access and helpfulness with LGBTQ+ young people: The importance of affirmation and understanding identity

Introduction LGBTQ+ young people report higher rates of mental health concerns than their heterosexual and cisgender peers, often seeking therapy to grow, heal, and navigate identity-related issues. However, little is known about therapy helpfulness from the client’s perspective, as well as barriers to receiving care, for LGBTQ+ young people (ages 13–24).Method Using a mixed-methods approach, this study explores barriers to receiving and benefiting from therapy for LGBTQ+ young people (N = 28,524).Results Topic modeling revealed that participants reported prioritizing a safe space, LGBTQ+ and mental health competency, respect and confidentiality, and affordability when seeking therapy. Closed-ended responses revealed that participants reported frequently wanting therapy, but facing access issues. For those who received therapy, over half found therapy helpful; however, helpfulness was related to whether their provider understood their identity. Demographic differences also emerged. Finally, LGBTQ+ young people that felt their LGBTQ+ identity (aOR = 8.11, 95% CI = 7.14–9.20, p < 0.001) and race/ethnicity (aOR = 4.01, 95% CI = 3.59–4.50, p < 0.001) were understood by their therapist had greater odds of finding therapy helpful compared to those who did not feel understood.Conclusion Recommendations are provided to improve therapy access and helpfulness for LGBTQ+ young people.